Enterovirus in the Neonate

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Primary Children's Hospital Resident Morning Report
  Morning Report Monday, 8/24/15Mitch Peterson  CC: Sleepy, stopped breathing, turned blue HPI: A 51 day old male ith a history o! birth at #$ ee%s and discharge !rom the &'() a!ter a 45 day stay presents a!ter he stopped breathing and turned blue at home* +e as acting li%e his normal sel! up until the morning o! presentation hen his mother as holding him* She noticed that he started loo%ing up and then stopped breathing* +e turned blue* +is mother gae him (PR and his color returned as he started to breathe again* -hey got into the car and started driing to the emergency department* .n the ay, he stopped breathing and turned blue again* -hey stopped the car and administered (PR again* +e again started to breathe and they ere able to ma%e it to the )niersity o! )tah mergency 0epartment*(ourse since arrial to the hospital 'n the )niersity o! )tah mergency 0epartment, he as !ound to be occasionally apneic ith desaturations into the $s and 8$s* +e had a temperature o! #8* celsius* 0irect admission to the P(+ P'()*  ROS: &o prior !eer, no rash, no cough, no congestion, no increased or% o! breathing, somehat decreased !eeding, seeral et diapers the day o! admit, emesis 3 1, no diarrhea, patient as ith his mother all day, no seating ith !eeds* PMH: orn at #$ ee%s because his mother had an in!ection* +e as not intubated, but needed a !eeding tube* +e as in the &'() !or 45 days or so* 0ischarged home on room air* +is !amily as told that he is remar%ably healthy !or a premature in!ant* &o surgeries* ot +epatitis  accine prior to discharge* Medications: &60A, Multiitamin Diet: &eosure 24 %cal/o7 FH/SH: &o %non inherited diseases o! childhood* ies ith his 2 older sisters, 2 older brothers, mother and !ather* -here are no smo%ers or pets in the house*   - #*$ +R 18# RR 28 P 84/1 Sp.2 98: on &asal (annula at 1 PM* ;t < 2*85 6g, =>5$:ile !or (A? +t < 4# cm =>15:ile !or (A?&RA lethargic in!ant, lying in crib, moing occasionally, crying only intermittently hen stimulated+A0 small area o! bruising on right anterior scalp, normocephalic, atraumatic, anterior !ontanelle open, so!t, and @at*S normal red re@e3 and pupillary re@e3es bilaterally, no conBunctial inBection*&.S nasal cannula in place ithout appreciable congestion.R.P+AR&C moist mucus membranes, no cle!t palate*(AR0'.DAS()AR tachycardic, normal rhythm, normal S1/S2, no murmur, no gallop, brachial/!emoral pulses 2E and symmetric, capillary reFll time # seconds*)&S clear to auscultation bilaterally, good air @o, no retractions*A0.M& so!t, non<tender, non<distended ith actie boel sounds and no hepatomegaly*C-RM'-'S all e3tremities arm and ell per!used* &o cyanosis, clubbing, or edema*&'-.)R'&AR normal Male e3ternal genitalia, -anner stage ', uncircumcised, red birthmar% near le!t inguinal canal area*&)R..'( sleepy and arouses !or short periods o! time only ith stimulation, normal tone, ea% suc%S6'& &o rashes, no mottling
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